Fiuza Felipe, Maluf-Filho Fauze, Ide Edson, Furuya Carlos Kiyoshi, Fylyk Sonia Nadia, Ruas Jennifer Nakamura, Stabach Luciana, Araujo Gabriela Albuquerque, Matuguma Sergio Eiji, Uemura Ricardo Sato, Sakai Christiano Makoto, Yamazaki Kendi, Ueda Sergio Shiguetoshi, Sakai Paulo, Martins Bruno Costa
Department of Endoscopy, Hospital Alemão Oswaldo Cruz, São Paulo 01323-020, Brazil.
World J Gastrointest Endosc. 2021 Oct 16;13(10):518-528. doi: 10.4253/wjge.v13.i10.518.
Many studies evaluated magnification endoscopy (ME) to correlate changes on the gastric mucosal surface with () infection. However, few studies validated these concepts with high-definition endoscopy without ME.
To access the association between mucosal surface pattern under near focus technology and infection status in a western population.
Cross-sectional study including all patients referred to routine upper endoscopy. Endoscopic exams were performed using standard high definition (S-HD) followed by near focus (NF-HD) examination. Presence of erythema, erosion, atrophy, and nodularity were recorded during S-HD, and surface mucosal pattern was classified using NF-HD in the gastric body. Biopsies were taken for rapid urease test and histology.
One hundred and eighty-seven patients were analyzed from August to November 2019. Of those, 47 (25.1%) were +, and 42 (22.5%) had a previous treatment. In the examination with S-HD, erythema had the best sensitivity for detection (80.9%). Exudate (99.3%), nodularity (97.1%), and atrophy (95.7%) demonstrated better specificity values, but with low sensitivity (6.4%-19.1%). On the other hand, the absence of erythema was strongly associated with - (negative predictive value = 92%). With NF-HD, 56.2% of patients presented type 1 pattern (regular arrangement of collecting venules, RAC), and only 5.7% of RAC+ patients were +. The loss of RAC presented 87.2% sensitivity for detection, 70.7% specificity, 50% positive predictive value, and 94.3% negative predictive value, indicating that loss of RAC was suboptimal to confirm infection, but when RAC was seen, infection was unlikely.
The presence of RAC at the NF-HD exam and the absence of erythema at S-HD were highly predictive of negative status. On the other hand, the loss of RAC had a suboptimal correlation with the presence of .
许多研究评估了放大内镜（ME），以将胃黏膜表面的变化与（）感染相关联。然而，很少有研究在没有ME的高清内镜下验证这些概念。
在西方人群中探讨近焦技术下黏膜表面形态与（）感染状态之间的关联。
横断面研究纳入所有接受常规上消化道内镜检查的患者。内镜检查先采用标准高清（S-HD），随后进行近焦（NF-HD）检查。在S-HD检查期间记录红斑、糜烂、萎缩和结节的存在情况，并使用NF-HD对胃体部的表面黏膜形态进行分类。取活检组织进行快速尿素酶试验和组织学检查。
2019年8月至11月共分析了187例患者。其中，47例（25.1%）为（）阳性，42例（22.5%）曾接受过（）治疗。在S-HD检查中，红斑对（）检测的敏感性最高（80.9%）。渗出物（99.3%）、结节（97.1%）和萎缩（95.7%）显示出较好的特异性值，但敏感性较低（6.4%-19.1%）。另一方面，无红斑与（）阴性密切相关（阴性预测值=92%）。采用NF-HD时，56.2%的患者呈现1型形态（集合小静脉规则排列，RAC），而RAC阳性患者中只有5.7%为（）阳性。RAC消失对（）检测的敏感性为87.2%，特异性为70.7%，阳性预测值为50%，阴性预测值为94.3%，表明RAC消失对确诊（）感染并非最佳指标，但当观察到RAC时，（）感染的可能性不大。
NF-HD检查时RAC的存在以及S-HD检查时无红斑高度提示（）阴性状态。另一方面，RAC消失与（）存在的相关性欠佳。
